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The impact of margin status determined by the one-millimeter rule on tumor recurrence and survival following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/68665

Title: The impact of margin status determined by the one-millimeter rule on tumor recurrence and survival following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma
Authors: Nitta, Takeo Browse this author
Nakamura, Toru Browse this author →KAKEN DB
Mitsuhashi, Tomoko Browse this author →KAKEN DB
Asano, Toshimichi Browse this author
Okamura, Keisuke Browse this author
Tsuchikawa, Takahiro Browse this author →KAKEN DB
Tamoto, Eiji Browse this author
Murakami, Soichi Browse this author
Noji, Takehiro Browse this author →KAKEN DB
Kurashima, Yo Browse this author →KAKEN DB
Ebihara, Yuma Browse this author →KAKEN DB
Nakanishi, Yoshitsugu Browse this author
Shichinohe, Toshiaki Browse this author →KAKEN DB
Hirano, Satoshi Browse this author →KAKEN DB
Keywords: Pancreatic ductal adenocarcinoma
Margin
1-mm rule
TNM
Disease-free survival
Issue Date: Apr-2017
Publisher: Springer
Journal Title: Surgery today
Volume: 47
Issue: 4
Start Page: 490
End Page: 497
Publisher DOI: 10.1007/s00595-016-1420-7
PMID: 27677294
Abstract: Purpose: The tumor-node-metastasis (TNM) classification defines R1 as the presence of tumor cells at the resection margin, while the current Royal College of Pathologists guidelines for pancreaticoduodenectomy specimens regard the presence of tumor cells within 1 mm from the resection margin as R1 (the "1-mm rule"). The aims of this study were to investigate the resection margin status of pancreatic head cancer retrospectively according to both the TNM and 1-mm rule classifications, and to evaluate the postoperative survival and tumor recurrence patterns. Methods: A total of 117 patients with pancreatic head cancer were the subjects of this study. Results: R1^1-mm rule resection was associated with a significantly worse disease-free survival (DFS) than R0^1-mm rule resection (p = 0.0259), while R1^TNM had no impact on DFS. R1^1-mm rule resection margin status correlated with the incidence of tumor recurrence in the liver (p = 0.0483). In a multivariate analysis, R1^1-mm rule resection was the independent variable for predicting poor DFS (hazard ratio 1.71; p = 0.0289). Conclusions: R1 resection margin status determined by the 1-mm rule may be an independent indicator for predicting disease recurrence, especially liver metastasis. These results may be useful for selecting the appropriate adjuvant therapy protocol and conducting strict surveillance in PDAC patients.
Rights: The final publication is available at link.springer.com
Type: article (author version)
URI: http://hdl.handle.net/2115/68665
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 中村 透

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